Summary. This study summarized 2001-9 period’s certain
experiences of Samara Region in primary-stage-prevention of pre-natal
pathologic developments in the fetus. Some organizational and
technological constituents of operation of units for disease prevention
in municipal medical establishments in this Region were selected for the
analysis of the situation with pre-gestation training. Evaluation of
efficiency of operation of such units was performed along a unique
measure, that was the rate of healthy born offspring. Two groups were
created: the group of parturient women who had received pre-gestational
training and the control group of non-receivers.
Parameter and none-parameter statistical techniques were implemented for statistical analysis.
Pre-gestational training for future expectant mothers/parturient
women including peri-conception disease-development-prevention measures
has been introduced in healthcare services as quite a novel facility
derived from units for disease prevention within gynecological clinic.
This innovation has become true with arranging coordination of
physicians of different specialties within the general algorithm of
consultation service. Logistics for patients supply, as well
standardized protocol of pre-gestation training of future expectant
mothers/parturient women were also necessary elaborations.
All-embracing verification of operation of establishments of primary
medical sanitary care, listening to projects-in-question at medical
boards of medical establishments, as well as at governing boards for
public health (from Municipal to Regional level), adoption of relevant
resolutions implying dynamic control for them were all necessary for the
creation and continuous improvement of these new medical services (i.e.
consultation and pre-gestational training of future expectant
mothers/parturient women).
This study demonstrated that pre-gestational training decreased the
risks of developing in-born malformation and other deviations in health
condition of future newborns.
Decreased rate of newborns with folate-dependent inborn
malformations, with nerve tube defects, an-encephalia, encephalocele,
spinal cord hernias, as well as with prominent iodine deficiency was
noted in birth outcomes with parturient women who had received
pre-gestation training. 62.7% of parturient women producing healthy
offspring had received pre-gestation training, while among those
producing diseased offspring it was only 12.3% (χ2=12.4; ð=0.026).
Cost-efficiency estimates demonstrated that pre-gestation training saved 7,000 rubles per each pregnant woman.
Key words. Pre-gestation training, units for disease-prevention, inborn malformations, morbidity in newborns.
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